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Anastomotic leak — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Anastomotic leakUSMLE Step 3

A patient on postoperative day 5 after low anterior resection develops fever, tachycardia, worsening abdominal pain, ileus, guarding, leukocytosis, and elevated lactate. Which complication is most likely?

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Correct answer: C — Anastomotic leak causing intra-abdominal sepsis and peritoneal irritation

Systemic deterioration with peritoneal signs after colorectal anastomosis strongly suggests leak and intra-abdominal sepsis. It needs urgent imaging, resuscitation, antibiotics, and source-control assessment.

Reference: American Society of Colon and Rectal Surgeons: Colon Cancer Expanded: https://fascrs.org/Web/Web/Patients/Diseases-and-Conditions/A-Z/Colon-Cancer-Expanded.aspx